The following questionnaire is for men wishing to learn more and, also for male patients to complete and submit at least 48 hours before attending their appointment, as it is extremely helpful for our specialist medical practitioners to have an overall view of individual symptoms beforehand.

Once your questionnaire has been received you will either be sent a confirmation email with any further information or, one of our Medical or Patient Liaison team will call you (if you’ve requested an appointment for example or have a health question).

By completing the questionnaire you are automatically entitled to a FREE 15 minute consultation with one of our Patient Liaison team.  All information is treated as confidential and is not passed to any third party for marketing purposes.  ‘*’ denotes a required field.

Click HERE for our Questionnaire for Women.

We do not pass this on
Ideally one that applies to daytime or evening - we do not pass this on.
* Treatment processes and costs are outlined under 'Pricing' in our menu bar above.
Were you referred to us by another practice, practitioner, clinic, salon or other?